Beech Tree House

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good.

This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them. People’s needs were thoroughly assessed prior to them moving into the home.

People had detailed and comprehensive care and support plans to provide guidance for staff which were reviewed and updated regularly, and when people’s needs changed. The provider was in the process of moving all care and support records to an electronic care planning and recording system. Staff accessed the electronic system on handheld devices. People’s past history and exposure to trauma was considered in all oftheir care planning. There was a trauma informed approach to understanding people’s needs throughout assessment and review. People’s communication needs had been assessed and staff had clear communication plans to follow. Where people used specific communication techniques such as signing systems or picture cards, resources and training were available for staff. We observed people using the picture cards available on the wall to indicate to staff when they wanted a snack or a drink and staff responded positively.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards. The provider used care and support methods that were evidence-based and in line with good practice.

Where people needed support to manage their emotions, behaviour and distress, they had Positive Behaviour Support plans in place to guide staff. These plans were thorough and had been developed, reviewed and updated by specialist professionals. One senior support worker told us, “I’ve had training and know how to redirect and anticipate people’s needs before situations escalate and avoid the behaviour. We always focus on the least restrictive alternatives, and you have to know the person very well [for this to be effective]”. We observed staff supporting people using intensive interaction techniques which is a Person-centred, responsive communication approach designed to build social inclusion and communication skills in individuals with learning difficulties, autism, dementia, or other conditions affecting social engagement. People who benefitted from this type of communication and social interaction had plans in place to support staff, with specific strategies and techniques to use that were meaningful to the person. We observed people responded very positively to these.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services. Staff were supported by a range of professionals, which helped to assist staff to provide safe and effective care to people. We saw people had input from psychiatrists, physiotherapists, speech and language therapists, epilepsy nurses and the provider’s Positive Behaviour Support team. We observed good communication between the support staff. The shift pattern was designed to provide adequate time and resources for detailed handovers between staff.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

Staff facilitated access to medical professionals when people needed it. One person said, “If I feel unwell the staff phone the GP, and take me to the appointment. Sometimes I just need some [paracetamol] and a lie down, rest helps a lot”.

Where people had specific medical needs, the provider ensured staff had the appropriate training and advice to meet these. The deputy manager told us how a nursing consultant supported staff to understand diabetes and provided some training on monitoring people’s glucose levels and how to respond, as well as diabetes awareness training.

We saw people were supported to eat a healthy and balanced diet. There wasfresh fruit and vegetables available, and the chef told us how they ensured these were included in people’s meals and snacks. Where people required special meal preparation, for example, for diabetes or to reduce the risk of choking, the chef and support staff were aware of these people and supported them in line with the guidelines from the appropriate professionals. The menu was varied, and we observed the food looked and smelled appetising, people were really enjoying it. One person said, “I love the food. We all generally like the same things, and the food is delicious”. Staff supported people to take exercise and enjoy the outdoors. Most people were supported by staff to walk outside each day, and the garden was extensive with equipment such as swings, a trampoline and a paddling pool to use at the appropriate times of the year. There were also two kick scooters and safety equipment such as helmets available for people to use when they wished. Where people were advised to lose or gain weight for their own health, staff supported them to modify their diets and exercise to work towards this.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves. People’s support was delivered consistently by staff, in a person-centred way that supported individual goals, ambitions and outcomes which was specific to their needs. Where people had input from specialist professionals for their care and support, staff monitored outcomes according to the requirement of the professionals. For example, one person was supported by the provider’s Positive Behaviour Support team and staff completed the relevant forms and ensured the records were up to date. This allowed for the strategies staff were using to support the person to be evaluated for effectiveness and improved if required. Staff understood the inequalities autistic people and people with a learning disability face when monitoring and improving outcomes. For example, one person found it difficult to socialise and had become isolated. The staff had slowly worked with them to build up their confidence and find ways for them to socialise in a way that felt safe and was fulfilling. One member of staff told us,” We encourage choices, food, activities, what to wear how to spend their time”.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. The provider had effective systems in place to ensure consent to care and support was provided, by the person themselves or through best interest’s decision-making if the person did not have capacity to understand and consent to their care and support themselves. Staff supported people to make choices about their day-to-day lives. Information about the choices people could make was included in their care and support plans, and strategies were included for staff to support people to make choices effectively.

The service provided information to people in a variety of formats to meet their communication needs. Some people used signing, whilst other people used pictures and objects of reference to make choices.